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ACUTE RESPIRATORY ILLNESS ADMISSIONS IN SOUTH AFRICAN CHILDREN DURING THE COVID-19 PANDEMIC
Abstract
Background
Distinguishing children with SARS-CoV-2 infection compared to other acute respiratory illnesses (ARIs) would assist treatment and infection control strategies, especially where resources are limited.
Aims
The study aim was to describe the profile and outcomes of SA children with ARI with and without SARS-CoV-2 infection.
Methods
In this cross-sectional study, we evaluated routinely collected clinical data of children 0-13 years presenting with ARIs to Tygerberg Hospital, Cape Town between May 2020- November 2020. SARS-CoV-2 PCR was performed on all admitted children presenting with respiratory symptoms.
Results
Data of 178 children was included. SARS-CoV-2 positive children (40/178, 22.5%) were younger (median 6.7 vs 17 months, p=0.09), had lower weight-for-age Z-score (-0.83 vs -0.54, p=0.02) and were more likely female (55% vs 38%, p<0.01). Underlying comorbidities were similar in both groups. Multivariable logistic regression analysis showed SARS-CoV-2 positive children more frequently presented with fever (OR 3.9, 95CI 1.7-8.8), and were less likely to have cough (OR 0.3 95CI 0.1-0.6).
Oxygen supplementation (73% vs 75%, p=0.79) and respiratory support (38% vs 26%, p=0.16) were similar between groups, but SARS-CoV-2 positive children were more likely to require PICU (18% vs 7%, p=0.03) and remain on oxygen (median 6 vs 2 days, p=0.01). Readmission within 3 months for respiratory reason was similar (18% vs 15%, p=0.64).
Conclusions
Clinical presentation between children with and without SARS-CoV-2 was comparable. Children with SARS-CoV-2 infection required longer oxygen supplementation and more PICU admissions. These findings suggest a potentially differential long-term outcome in children with SARS-CoV-2 which requires further investigation.